TY - JOUR
T1 - Trends in Polypharmacy in Japan
T2 - A Nationwide Retrospective Study
AU - Onoue, Hiroshi
AU - Koyama, Toshihiro
AU - Zamami, Yoshito
AU - Hagiya, Hideharu
AU - Tatebe, Yasuhisa
AU - Mikami, Naoko
AU - Shinomiya, Kazuaki
AU - Kitamura, Yoshihisa
AU - Hinotsu, Shiro
AU - Sendo, Toshiaki
AU - Ouchi, Yasuyoshi
AU - Kano, Mitsunobu R.
N1 - Funding Information:
From the *Departments of Pharmaceutical Biomedicine; †Clinical Evaluation and Development of Pharmaceutical Biomedicine; ‡Education and Research Center for Clinical Pharmacy; §Department of Clinical Pharmacology and Therapeutics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan; ¶Division of Infection Control and Prevention, Osaka University Hospital, Osaka, Japan; kDepartment of Pharmacy, Okayama University Hospital, Okayama, Japan; **Division of Pharmacy, Chiba University Hospital, Chiba, Japan; ††Department of Toji Pharmacy, SSmile Co., Ltd., Hiroshima, Japan; ‡‡Department of Biostatistics and Clinical Epidemiology, Sapporo Medical University, Hokkaido, Japan; §§Federation of National Public Service Personnel Mutual Aid Associations, Toranomon Hospital, Tokyo, Japan; ¶¶Department of Geriatric Medicine, University of Tokyo, Tokyo, Japan; and the kkDepartment of Pharmaceutical Biomedicine, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan.
PY - 2018/12
Y1 - 2018/12
N2 - Objectives: To describe and examine trends in polypharmacy according to age in Japan from 2010 to 2016. Design: Retrospective observational study. Setting: Outpatient settings. Participants: Japanese individuals aged 20 and older. Measurements: We analyzed pharmacy claims data that the Japanese Ministry of Health, Labor, and Welfare provided in the Survey of Medical Care Activities in Public Health Insurance from 2010 to 2016. The use of 5 or more oral prescription medications per month was defined as polypharmacy and of 10 or more as excessive polypharmacy. Regression analysis was used to estimate trends in polypharmacy with annual percentage changes. Using number of medications (polypharmacy vs excessive polypharmacy), trends in polypharmacy and crude and age-adjusted rates of polypharmacy per 1,000 persons were calculated according to year and age group (20–34, 35–49, 50–64, 65–79, ≥ 80). Results: We analyzed 240 million pharmacy claims data. The age-adjusted monthly prevalence rate of polypharmacy increased from 85.2 to 93.8 per 1,000 persons per month and of excessive polypharmacy from 13.6 to 14.0 per 1,000 persons per month from 2010 to 2016 in the entire study population. The highest rate of polypharmacy (per 1,000 persons) was observed in 2016 in those aged 80 and older (326.8), followed by those aged 65 to 79 (167.3). The polypharmacy rate increased by 6.3% (95% confidence interval (CI)=4.0–8.7) per year from 2010 to 2012, then decreased by 0.7% (95% CI=–1.3–0.0) per year from 2012 to 2016. The rate of excessive polypharmacy increased by 4.5% (95% CI=1.1–8.0) per year from 2010 to 2013 and then decreased by 3.7% (95% CI=–6.7 to –0.6) per year from 2013 to 2016. Conclusion: The overall trend of polypharmacy in Japan increased during the study period, although the increase ceased in 2013 and then declined from 2013 to 2016. Policy changes in Japan might be responsible for some of the changes. J Am Geriatr Soc 66:2267–2273, 2018.
AB - Objectives: To describe and examine trends in polypharmacy according to age in Japan from 2010 to 2016. Design: Retrospective observational study. Setting: Outpatient settings. Participants: Japanese individuals aged 20 and older. Measurements: We analyzed pharmacy claims data that the Japanese Ministry of Health, Labor, and Welfare provided in the Survey of Medical Care Activities in Public Health Insurance from 2010 to 2016. The use of 5 or more oral prescription medications per month was defined as polypharmacy and of 10 or more as excessive polypharmacy. Regression analysis was used to estimate trends in polypharmacy with annual percentage changes. Using number of medications (polypharmacy vs excessive polypharmacy), trends in polypharmacy and crude and age-adjusted rates of polypharmacy per 1,000 persons were calculated according to year and age group (20–34, 35–49, 50–64, 65–79, ≥ 80). Results: We analyzed 240 million pharmacy claims data. The age-adjusted monthly prevalence rate of polypharmacy increased from 85.2 to 93.8 per 1,000 persons per month and of excessive polypharmacy from 13.6 to 14.0 per 1,000 persons per month from 2010 to 2016 in the entire study population. The highest rate of polypharmacy (per 1,000 persons) was observed in 2016 in those aged 80 and older (326.8), followed by those aged 65 to 79 (167.3). The polypharmacy rate increased by 6.3% (95% confidence interval (CI)=4.0–8.7) per year from 2010 to 2012, then decreased by 0.7% (95% CI=–1.3–0.0) per year from 2012 to 2016. The rate of excessive polypharmacy increased by 4.5% (95% CI=1.1–8.0) per year from 2010 to 2013 and then decreased by 3.7% (95% CI=–6.7 to –0.6) per year from 2013 to 2016. Conclusion: The overall trend of polypharmacy in Japan increased during the study period, although the increase ceased in 2013 and then declined from 2013 to 2016. Policy changes in Japan might be responsible for some of the changes. J Am Geriatr Soc 66:2267–2273, 2018.
KW - Japan
KW - aged
KW - outpatient
KW - pharmacy claims data
KW - polypharmacy
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U2 - 10.1111/jgs.15569
DO - 10.1111/jgs.15569
M3 - Article
C2 - 30291747
AN - SCOPUS:85054499756
VL - 66
SP - 2267
EP - 2273
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
SN - 0002-8614
IS - 12
ER -